COIN: Christians On the InterNet

COIN: Christians on the Internet Membership Application Form
Please print this form, complete all the information and send it, together with a one-off joining fee of 5 UK Pounds (cheque payable to "COIN") to: The Rev. A. F. Jesson The Rectory 5 New Road Upwell, WISBECH Cambridgeshire PE14 9AB
Title (Mr/Mrs/Rev/etc.):	_________________
Name:	_____________________________________________
Email Address:*	_____________________________________________
Postal Address:	_____________________________________________
	_____________________________________________
	_____________________________________________
Postcode:	_____________________________________________
Telephone Number:	_____________________________________________
Fax Number:	_____________________________________________
I wish to apply for membership of COIN. I qualify to apply for membership under clause 5 of the Constitution. I enclose my joining fee of 5 pounds.
Signed:	_____________________________________________
Date:	_____________________________________________
*If no email address is given this application will be entered as Associate Membership. When an email address is obtained please advise the Membership Secretary (membership@coin.org.uk) and membership will be converted to Full Membership.

Return to Home Page Go to Top of Document

COIN: Christians on the Internet Membership Application Form